Pancreas and Islet Transplantation

Abstract

The aim of pancreas and islet transplantation is to establish the same status of glucose control that is provided by endogenous secretion of insulin from a healthy native pancreas in order to improve the quality of life and ameliorate secondary diabetic complications in patients with type I insulin-dependent diabetes mellitus (IDDM). Islet transplantation is, theoretically, an ideal solution for patients with IDDM since it is not a major procedure, can be performed radiologically and can be repeated several times without any major discomfort to the patient, but despite experimental and clinical efforts over the past 25 years, long term and consistent insulin independence has not yet been achieved. Pancreas transplantation is indicated for patients with IDDM following also additional selection criteria. In a suitable candidate, the evaluation is also needed to determine the type of pancreas transplantation, based mainly on the degree of nephropathy. Details of the recipient operation together with the anti-reject procedures and actual global results are described analytically. Similar considerations are dedicated to the islet transplantation procedure.